ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP PRSYM
    • 2016-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 1408

Treatment of Giant Cell Arteritis in the ARTESER Multicenter Study of 1675 Patients

Jesús T. Sánchez-Costa1, Iñigo Hernández-Rodríguez2, Elisa Fernández-Fernández3, María T. Silva-Diaz4, Jesús A. Valero-Jaimes5, Ismael González-Fernández6, Julio Sánchez7, Judit Lluch8, Eva Galindez-Agirregoikoa9, Javier Mendizábal-Mateos10, Pia M. Lois Bermejo11, Javier Loricera12, Alejandro Muñoz13, Cristina Valero-Martínez14, Patricia Moya15, Carmen Larena-Grijalba16, Vanessa A. Navarro-Angeles17, Joan Calvet-Fontova18, Ivette Casafont19, Francisco Ortiz-Sanjuán20, Selene Labrada-Arrabal21, Jaime Calvo-Alén22, Carlota L. Iñiguez-Ubiaga23, Vanesa Hernández24, Cristina Campos-Fernández25, María Alcalde-Villar26, Antonio Juan-Mas27, Eugenio De Miguel28, Javier Narvaez29, Miguel Ángel gonzalez-Gay30, Noemí Garrido-Puñal31, Paula V. Estrada-Alarcon17 and Ricardo Blanco32, 1Spanish Society of Rheumatology, Madrid, Spain, 2Complejo Hospitalario Universitario de Vigo, Vigo, Spain, 3Rheumatology department, La Paz University Hospital, Madrid, Spain, 4Complejo Hospitalario Universitario de La Coruña, Coruña, Spain, 5Hospital Universitario Donostia, Donostia-San Sebasti, Spain, 6Hospital Universitario de León, León, Spain, 7Hospital Universitario 12 de Octubre, Madrid, Spain, 8Hospital Universitari Bellvitge, Hospitalet de Llobregat, Spain, 9Hospital Universitario de Basurto, Bilbao, Spain, 10H. Navarra, Navarra, Spain, 11Rheumatology Department, Hospital Clínico San Carlos, Madrid, Spain, 12Hospital Universitario Marqués de Valdecilla, Santander, Spain, 13Hospital Universitario Virgen del Rocío, Sevial, Spain, 14Hospital Universitario de La Princesa, Madrid, Spain, 15Hospital Sant Pau, Barcelona, Spain, 16Rheumatology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain, 17Hospital de Sant Joan Despí Moisès Broggi. Sant Joan Despí, Barcelona, Spain, 18Hospital Universitari Parc Tauli, Sabadell, Spain, 19Hospital Universitari Germans Trias i Pujol, Barcelona, Badalona, Spain, 20H. La Fe, Valencia, Spain, 21Hospital del Mar, Barcelona, Spain, 22Rheumatology Department, Hospital Universitario Araba, Vitoria-Gasteiz, Spain, 23Hospital Universitario Lucus Augusti, Lugo, Spain, 24Rheumatology Department, Hospital Universitario de Canarias, La Laguna, Spain, 25Consorci Hospital General Universitari de Valencia, Valencia, Spain, 26Hospital Universitario Severo Ochoa, Leganés, Spain, 27Hospital Universitario Son Llàtzer, Palma de Mallorca, Spain, 28Hospital Universitario La Paz, Madrid, Spain, 29Division of Rheumatology, Hospital Universitario de Bellvitge, Barcelona, Spain, 30Research group on Genetic Epidemiology and Atherosclerosis in Systemic Diseases and in Metabolic Bone Diseases of the Musculoskeletal System, IDIVAL, Division of Rheumatology, Hospital Universitario Marqués de Valdecilla; School of Medicine, Universidad de Cantabria, Santander, Spain. Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa, 31Hospital Universitario Virgen del Rocío, Sevilla, Spain, 32Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain

Meeting: ACR Convergence 2021

Keywords: corticosteroids, giant cell arteritis, glucocorticoids, longitudinal studies, Vasculitis

  • Tweet
  • Email
  • Print
Session Information

Date: Monday, November 8, 2021

Session Title: Vasculitis – Non-ANCA-Associated & Related Disorders Poster I: Giant Cell Arteritis & Polymyalgia Rheumatica (1391–1419)

Session Type: Poster Session C

Session Time: 8:30AM-10:30AM

Background/Purpose: Glucocorticoids (GC) are the mainstay therapy in Giant Cell Arteritis (GCA), initially at high doses (40-60 mg/day) followed by gradual glucocorticoid tapering. This treatment, especially in older patients, is associated with numerous adverse effects (AE). In addition, there are frequent relapses. Therefore, conventional synthetic immunosuppressants such as methotrexate (MTX), leflunomide, azathioprine, cyclophosphamide or mycophenolate, have been used with controversial results. Studies with biological immunosuppressants, such as TNFi have been ineffective; in contrast, tocilizumab (TCZ) has obtained positive results and was approved for the treatment of GCA.

In the ARTESER study we describe a) treatment with GC, synthetic or biological immunosuppressants and concomitant treatments; b) AE of CG; and c) evolution.

Methods: ARTESER is a retrospective observational study sponsored by the Spanish Society of Rheumatology. 26 Spanish centers participated and all new patients diagnosed with GCA from June 1, 2013 to March 29, 2019 were included. Data on GC and immunosuppressants were collected at the beginning and during the follow-up of GCA patients. For the calculation of the cumulative dose of GC, an application was developed that, by including the periods of time, dose and type of GC received during follow-up, performs the automatic calculation in mg of prednisone.

Results: Of the 1675 patients included, GC treatment was adequately recorded in 1650 patients (Table 1). All received oral treatment, being prednisone the most frequently drug used (N=1602, 97.09%). In addition, 426 (25.82%) patients received at least one iv pulse of methylprednisolone, being the 1000 mg regimen the most frequent (n=217; 50.9%). The total mean duration of GC treatment was 22.65 months. The mean cumulative dose per patient at the end of follow-up was 8514.98 mg of prednisone.

The most prescribed concomitant treatment at the time of diagnosis of GCA was calcium (n=1281, 76.9%), vitamin D (n=1258, 75.6%) and bisphosphonates (n=831, 50.1%). The most widely used immunosuppressant was MTX both at diagnosis (n=165; 9.9%) and during follow-up (n=532; 31.8%), followed by TCZ, at diagnosis (22; 1.3%) and at follow-up (153; 9.1%).

AE with GC were described in 393 patients (23.8%), highlighting serious infections (n=67; 10.03%) followed by diabetes mellitus (n=63; 9.43%), steroid myopathy (n=53; 7.9%), vertebral fractures (n=47; 7.04%), non-vertebral fractures (n=36; 5.39%), heart failure (n=36; 5.39%), arterial hypertension (n=34; 5.09%) and neuropsychiatric alterations (n=27; 4.04%).

During the follow-up, 334 (19.9%) patients had relapses, 532 (31.8%) were hospitalized on some occasion, and 142 patients (8.48%) died. The main cause of death were infections (n=44; 30.99%), neoplasms (n=23; 16.2%), cardiovascular (n=15; 10.56%), and cerebrovascular (n=10; 7.04%).

Conclusion: The main treatment for GCA was oral GC, which were required for almost two years on average, in a quarter of patients associated with IV pulses. The cumulative steroid dose was high as well as the side effects. MTX was the most widely used immunosuppressant and TCZ was prescribed in 10%. Relapses and admissions at the hospital were relatively frequent.

Table 1. Corticosteroid treatment

Table 2. Immunosuppressant and concomitant treatments


Disclosures: J. Sánchez-Costa, None; I. Hernández-Rodríguez, None; E. Fernández-Fernández, None; M. Silva-Diaz, None; J. Valero-Jaimes, None; I. González-Fernández, None; J. Sánchez, None; J. Lluch, None; E. Galindez-Agirregoikoa, None; J. Mendizábal-Mateos, None; P. Lois Bermejo, None; J. Loricera, None; A. Muñoz, None; C. Valero-Martínez, None; P. Moya, None; C. Larena-Grijalba, None; V. Navarro-Angeles, None; J. Calvet-Fontova, None; I. Casafont, None; F. Ortiz-Sanjuán, None; S. Labrada-Arrabal, None; J. Calvo-Alén, None; C. Iñiguez-Ubiaga, None; V. Hernández, None; C. Campos-Fernández, None; M. Alcalde-Villar, Nordic, 12, Tutor of rheumatology trainee at regional congress; A. Juan-Mas, None; E. De Miguel, Roche, 6, 12, Paid instructor, Abbvie, 2, 5, 6, Novartis, 2, 5, 6, 12, Paid instructor, Pfizer, 2, 5, 6, MSD, 6, BMS, 6, UCB, 6, Grunental, 6, Janssen, 6, 12, Paid instructor, Sanofi, 6, Galapagos, 2; J. Narvaez, None; M. gonzalez-Gay, None; N. Garrido-Puñal, None; P. Estrada-Alarcon, None; R. Blanco, Brystol Myers Squibb, 6.

To cite this abstract in AMA style:

Sánchez-Costa J, Hernández-Rodríguez I, Fernández-Fernández E, Silva-Diaz M, Valero-Jaimes J, González-Fernández I, Sánchez J, Lluch J, Galindez-Agirregoikoa E, Mendizábal-Mateos J, Lois Bermejo P, Loricera J, Muñoz A, Valero-Martínez C, Moya P, Larena-Grijalba C, Navarro-Angeles V, Calvet-Fontova J, Casafont I, Ortiz-Sanjuán F, Labrada-Arrabal S, Calvo-Alén J, Iñiguez-Ubiaga C, Hernández V, Campos-Fernández C, Alcalde-Villar M, Juan-Mas A, De Miguel E, Narvaez J, gonzalez-Gay M, Garrido-Puñal N, Estrada-Alarcon P, Blanco R. Treatment of Giant Cell Arteritis in the ARTESER Multicenter Study of 1675 Patients [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 10). https://acrabstracts.org/abstract/treatment-of-giant-cell-arteritis-in-the-arteser-multicenter-study-of-1675-patients/. Accessed May 25, 2022.
  • Tweet
  • Email
  • Print

« Back to ACR Convergence 2021

ACR Meeting Abstracts - https://acrabstracts.org/abstract/treatment-of-giant-cell-arteritis-in-the-arteser-multicenter-study-of-1675-patients/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2022 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.